The Trump administration has authorized Immigration and Customs Enforcement to access personal data from nearly 79 million Medicaid enrollees, triggering a wave of legal and political opposition from states and privacy advocates. The move, first reported by the Associated Press, is part of a broader effort by the White House to intensify immigration enforcement and deportations nationwide.
A data-sharing agreement between the Department of Homeland Security and the Centers for Medicare and Medicaid Services will allow ICE to search a federal database containing names, addresses, birth dates, Social Security numbers, and racial and ethnic identifiers of Medicaid recipients. According to DHS spokesperson Tricia McLaughlin, the initiative is designed to ensure "illegal aliens are not receiving Medicaid benefits that are meant for law-abiding Americans."
"This is about the weaponization of data, full stop," said Rep. Pramila Jayapal (D., Wash.) in a statement. "Trump said he would go after the 'worst of the worst' immigrants, yet now is giving ICE EVERYONE's Medicaid data."
The database access will be restricted to weekday working hours and ICE will not be allowed to download any information, according to the agreement. Yet critics say even the existence of the agreement is likely to deter eligible recipients-including U.S. citizen children of undocumented parents-from seeking critical care.
California Attorney General Rob Bonta announced that his state, along with 18 others including New York, New Jersey, Connecticut, and Oregon, is seeking an emergency court order to block the data transfer. "The president's efforts to pull personal, private, and unrelated health data to create a mass deportation machine cannot be allowed to continue," Bonta stated.
HHS spokesperson Emily Hilliard defended the policy, saying it complies with all applicable laws and serves to "ensure that Medicaid benefits are reserved for individuals who are lawfully entitled to receive them." She added, "We are not only protecting taxpayer dollars - we are restoring credibility to one of America's most vital programs."
However, an internal CMS memo obtained by the AP showed the agency's own deputy director, Sara Vitolo, had warned that "multiple federal statutory and regulatory authorities do not permit CMS to share this information with entities outside of CMS."
While undocumented migrants are generally ineligible for Medicaid, federal law mandates that all states provide emergency Medicaid for life-saving services, regardless of immigration status. According to the Kaiser Family Foundation, eligible noncitizen immigrants account for just 6% of total Medicaid enrollees.
The Trump administration's data-sharing push comes on the heels of a broader crackdown on undocumented immigrants. Arrests are expected to rise to 3,000 per day-up from about 650 daily during the first five months of the administration. Tactics have included targeting migrants at courthouses, churches, farms, and construction sites.
"This is a privacy violation of unprecedented proportions and betrayal of trust," said Ben D'Avanzo, healthcare strategist at the National Immigration Law Center. "The government has explicitly said, for decades, that this information will never be used for immigration enforcement."
A federal hearing is scheduled for August 7 to consider the legality of the new data-sharing policy.
